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NPI Code Detail

MEDICARE: MRS. DIANE MORRIS REICH MS, CNC

MEDICARE: MRS. DIANE MORRIS REICH MS, CNC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133NN1002XNutrition Education Nutritionist

General Provider Information

NPI Number : 1912236647
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DIANE MORRIS REICH MS, CNC
Provider Business Mailing Address
First Line : 10260 SW GREENBURG RD
Second Line : SUITE 400
City : PORTLAND
State : OR
Zip : 97223-5500
Country : US
Telephone Number : 503-341-1075
Fax Number : 503-293-8499
Provider Business Practice Location Address
First Line : 10260 SW GREENBURG RD
Second Line : SUITE 400
City : PORTLAND
State : OR
Zip : 97223-5500
Country : US
Telephone Number : 503-341-1075
Fax Number : 503-293-8499
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2009
Last Update Date : 12/08/2009

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